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Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents
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Abstract

urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed to compare the analgesic efficacy and safety of paracetamol, diclofenac, and ketorolac when used after appendectomy and to assess their efficacy regarding nausea and vomiting in children and adolescents. A randomized, single-blinded, comparative, observational prospective clinical study was carried out on patients diagnosed with acute appendicitis and assigned for emergent appendectomy between October 2018 to May 2019 in Al- Zahraa Teaching Hospital in Al-Najaf province, Iraq.120 patients were randomly distributed into three groups who received diclofenac sodium suppositories (2mg/kg), IV Paracetamol )15mg/ kg every 6 hr.(, and IV  Ketorolac )0.5mg/ kg( immediately after surgery. All patients were observed for pain, nausea and vomiting and bleeding. Patients received ketorolac had a high percentage of the decrease in pain score between 30 and 60 min. after surgery, while paracetamol was the next and diclofenac sodium was the last. Regarding nausea and vomiting after surgery, ketorolac had higher percentage of the decrease in nausea, vomiting score during first day after surgery followed by diclofenac and paracetamol respectively. The present study also showed that there is no significant difference between groups regarding bleeding after surgery. It is concluded that ketorolac has higher analgesic efficacy compared with paracetamol and diclofenac with no risk of nausea and vomiting and bleeding when used after appendectomy.

Keywords: Postoperative pain, Ketorolac, Diclofenac, Paracetamol, Appendectomy.

 

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Publication Date
Mon Jul 01 2024
Journal Name
Civil Engineering Journal
The Effect of Oil Contaminated on Collapse Pattern in Gypseous Soil Using Particle Image Velocimetry and Simulation
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Gypseous soil covers approximately 30% of Iraqi lands and is widely used in geotechnical and construction engineering as it is. The demand for residential complexes has increased, so one of the significant challenges in studying gypsum soil due to its unique behavior is understanding its interaction with foundations, such as strip and square footing. This is because there is a lack of experiments that provide total displacement diagrams or failure envelopes, which are well-considered for non-problematic soil. The aim is to address a comprehensive understanding of the micromechanical properties of dry, saturated, and treated gypseous sandy soils and to analyze the interaction of strip base with this type of soil using particle image

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of measurement and analysis of quality costs on continuous improvement: Applied research in the Directorate General for the distribution of electric power in the Middle Euphrates
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The research aims to identify the theoretical foundations for measuring and analyzing quality costs and continuous improvement, as well as measuring and analyzing quality costs for the Directorate of Electricity Supply / Middle Euphrates and continuous improvement of the distribution of electrical energy,The problem was represented by the high costs of failure and waste in electrical energy result to the excesses on the network and the missing (lost) energy,Thus, measuring and analyzing quality costs for the distribution of electrical energy and identifying continuous improvement leads to a reduction in missing and an increase in sales, as the research reached many conclusions, the most important of which is the high percentage o

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Publication Date
Thu Mar 20 2025
Journal Name
Tikrit Journal Of Engineering Sciences
Effect of Different Compressor Speeds on the Energy and Exergy of an Automobile Air-Conditioner Using R134a in the Absence and Presence of a Liquid-Suction Heat Exchanger
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Refrigerant R134a has been widely utilized in automotive air conditioning systems (AACSs); R134a has a high global warming potential (GWP) of 1430 despite having zero ozone depletion potential (ODP). Coming refrigeration systems must include refrigerants with low GWP and zero ODP. The aim of this experimental study is to evaluate the thermal performance of an (AAC) with different values of compressor speeds, i.e., (1000, 1700, and 2400 rpm) and two thermal loads, i.e., (500 and 1000 Watt) with the absence and presence of liquid suction heat exchanger (LSHX) using R134a. The results showed that adding LSHX enhanced the COP cycle by 7.18%, 10.7%, and 3.09% for the first, second, and third speed, respectively, at 500 Watt, while the en

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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
The Impact of Prophylactic Dexamethasone, Metoclopramide or both on Nausea and Vomiting After Laparoscopic Cholecystectomy
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Background: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.

Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.

Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de

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Publication Date
Sun Jul 03 2022
Journal Name
International Journal Of Health Sciences
effects of toxoplasmosis infection on the levels of IL-18 and anti-ds-DNA antibodies in SLE patients
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The present study was set to demonstrate the prevalence of toxoplasmosis infection and its effects on patients with systemic  lupus erythematosus (SLE) through determining their serum levels of anti-dsDNA and IL-18 antibodies. For this purpose, the sera from 132 SLE and/or toxoplasmosis patients and 30 healthy women, were collected. The study sample was divided into four groups of SLE, toxoplasmosis, SLE coinfected with toxoplasmosis, and healthy control. Anti-Toxoplasma IgG antibodies were examined for all the samples using ELISA kit. The results showed a high mean level of anti-Toxoplasma IgG among SLE patients coinfected with toxoplasmosis (104.8792±12.31585pg/ml) in comparison to that in toxoplasmosis patients (91.1705±12.577

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Publication Date
Mon May 31 2021
Journal Name
Iraqi Geological Journal
Effect of Shatt Al-Arab Salinity on the Groundwater of Al-Fao and Al-Siba in Southern Iraq
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This study was conducted to estimate the extent of damage to the population in Basra, southern Iraq, specifically the areas adjacent to the Shatt al-Arab and the Arabian Gulf, which are the Al-Fao district and the Al-Siba region. They are affected by the progression of saline water resulting from the lack of water imports and the Karun River interruption, which led to high concentrations of salts in the Shatt Al-Arabs. Consequently, its effect on lands and all life types in these areas requires correcting a map of the study area to drop the groundwater sites as well as calculate the total dissolved salts, electrical conductivity and pH. This study concluded that the groundwater contains very high percentages of total dissolved solid

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Publication Date
Sun Jun 06 2010
Journal Name
Baghdad Science Journal
Effect of the aqueous extract of Banana Fruits Peal Musa paradisiaca on Mitosis in Plant and Mammalian cells
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The aqueous extract of banana fruits peal was tested for its effect on mitosis . The root tips of Allium cepa were used as plant test system and the bone marrow cells of the albino mice Mus musculus were used as mammalians test system in vivo .Root tips of Allium cepa were treated for four hours with five concentrations of the extract (5 , 10 , 20 , 40 ,60 mg / ml.).The Metaphase was arrested in all the treatments , the highest percentage ( 100 % ) was recorded in the first concentration , the last concentration caused stickiness and clumping of the chromosomes. The treatments did not cause significant difference in the mitotic index. The peals extract (5 mg /ml) was compared with the extracts of fruits bulb, leaves and roots of

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Publication Date
Sun Jun 06 2010
Journal Name
Baghdad Science Journal
Effect of the aqueous extract of Banana Fruits Peal Musa paradisiaca on Mitosis in Plant and Mammalian cells
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The aqueous extract of banana fruits peal was tested for its effect on mitosis . The root tips of Allium cepa were used as plant test system and the bone marrow cells of the albino mice Mus musculus were used as mammalians test system in vivo .Root tips of Allium cepa were treated for four hours with five concentrations of the extract (5 , 10 , 20 , 40 ,60 mg / ml.).The Metaphase was arrested in all the treatments , the highest percentage ( 100 % ) was recorded in the first concentration , the last concentration caused stickiness and clumping of the chromosomes. The treatments did not cause significant difference in the mitotic index. The peals extract (5 mg /ml) was compared with the extracts of fruits bulb, leaves and r

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Context and its impact on the choice of Quranic singularity An applied study in some verses of repetition
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The research dealt with the study of choice between a range of different words between the repetitive texts in the verses of the Koran and explain the reason behind this choice, and how the context has the greatest impact in this choice, and that each word in the Koran was placed in the most appropriate place, which can not be replaced by equivalent words, whatever The degree of similarity between them in the indication of the other because it remains at the end that each of those vocabulary synonyms are indicative, the first of them especially that makes the possibility of replacing them with the equivalent vocabulary impossible, and the second general significance and this connotation makes them share with their peers In one aspect of

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Publication Date
Fri Jul 01 2016
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
STUDY THE EFFECT OF DIFFERENT TYPES OF STRESS ON SOME BLOOD CONSTITUENTS AND PLASMA BIOCHAMICALS IN MALE RATS
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    The objective of this work was to determine and compare the physiological changes in some: blood components (packed cell volume and hemoglobin) and plasma biochemical parameters (glucose, total protein, albumin, cholesterol and triglycerides) under 3 day of different types of stress: water deprivation, starvation, overcrowding and handling stress. Twenty five male Wister rats weighted 100-120 gm, were divided randomly into five groups: control, water deprivation, starvation, overcrowding and handling stress. On the third day of stress the animals anesthetized for blood collection; the results of blood component revealed a significant increase in PCV and a significant decrease in Hb of water deprivation group and starva

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